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Helping Refugees in Rhode Island

Carol Lewis, MD

The United States is known for its diverse population and immigrants from countries all over the world. Many are refugees, fleeing their homes and everything they know to escape political, religious, or ethnic persecution, violence, war, or famine.

The smallest state is no exception, and here in Rhode Island, we offer safe haven for refugees from many countries. Families leave areas such as Burundi, Nepal, Iraq, Syria, Somalia, Congo, Afghanistan, Liberia, Myanmar, and Eritrea to resettle in Rhode Island. About half of these refugees are children.

Care and comfort

At Hasbro Children’s Hospital, we offer a refugee health clinic. We provide initial evaluation, screening, and ongoing primary preventive health care for refugee children resettling in Rhode Island. We care for between 40 and 120 newly arrived refugee children each year, as well as ongoing primary care for about 500 refugees.

Their health issues

Refugees often arrive with exposures to infectious diseases, dental problems, lead exposure, under-immunization, inherited or congenital disorders, such as sickle cell disease, nutritional deficits, and delay or interruption in their education. These children have been separated from their homes and families. Some may have witnessed a great deal of violence. That, combined with the stress of resettling in a new, foreign land, often results in mental health issues as well.

Other challenges

Refugees most commonly arrive without speaking English and have no knowledge of preventive health and medical care in the US. Navigating our health care system can be complicated for many, but it is particularly difficult for refugee families. They face significant financial burdens, an unfamiliarity with making appointments, and difficulty in understanding instructions and how to follow through with recommendations.

Learning English as a second language is a challenge and takes time, but one that I uniformly see both children and their parents eagerly tackle. Children have often had their education interrupted and require support at school as well as language instruction.

Isolation is one of the biggest challenges facing refugees. Many have been separated from their families and all they know. Often, they are shunned or rejected, and refugee children are frequently targets of bullying.

We have developed a “medical home” so the care of these children can be well coordinated. That includes integrated behavioral and mental health services directly in the primary care setting.

A St. Joseph’s Dental Center resident is part of the team during intake exams for newly arrived patients to help ensure ongoing oral health care. Hasbro Children’s Hospital’s pediatric primary care also provides support for our refugees through the Connect for Health program. This program assists families with fundamental needs such as food, housing, transportation, and infant and family health supplies.

Families also have access to the Medical Legal Partnership at Hasbro Children’s Hospital, which assists members of our community with access to needed legal support.

A community health worker program has been developed through a partnership with leaders in the refugee community and DIIRI. Through this program, leaders from the refugee community are trained to be health navigators, educators, promoters, and advocates for newly arrived refugees.

In partnership with The Warren Alpert Medical School of Brown University, the Refugee Health Program supports Brown University Youth Tutoring and Enrichment, which provides in-home tutoring and mentorship to assist refugee children in their educational success.

We have also been fortunate to have a Refugee Health Special Purpose Fund that provides support for resettling refugees when certain items are not covered by other resources. Examples include soccer cleats for a middle schooler not allowed to play on school team without appropriate shoes, bed-wetting alarms, or SAT prep classes for a bright high school student who is unfamiliar with standardized tests.